Nurse Practitioners

If a nurse practitioner and radiographer perform a PICC line insertion can a radiologist claim for the associated digital subtraction angiography?

13 November 24

A PICC line insertion is performed by a nurse/nurse practitioner and radiographer, including imaging (Fluoroscopy + Digital Subtraction Angiography of thorax). Post examination, a radiologist reviews the images and confirms the positioning and readiness of the PICC line. Noting that the initial catheterisation procedure (13815) cannot be claimed as a nurse performed the procedure, could the radiologist claim for the relevant DSA imaging charge (e.g. 60012)?

Can a nurse practitioner bill Medicare for public outpatients when the nurse practitioner is simultaneously being paid by a hospital that does not have a section 19(2) exemption?

30 September 24

I’m a Nurse Practitioner working in a small rural centre. I am a public employee 4 days a week and work privately on one day in the co-located primary health clinic/urgent care centre, which I bulk bill. A GP has left, and I have been asked to cover the clinic on two of my hospital days until a replacement is found. On these two days I am paid by the hospital as I still cover the emergency department. I have been asked to bulk bill the patients I see at the clinic on these two days even though I will be simultaneously being paid by the hospital. Both entities are wholly owned by the public health service, and it does not have a section 19(2) exemption. The GPs who work in the clinic are not employees of the public health service like me.

Can a fellow of the Australasian College for Emergency Medicine (FACEM) bill MBS codes outside of a private emergency department?

24 September 24

This FACEM was planning to open a walk-in emergency clinic similar to a GP urgent care centre. Importantly, this would not be an approved private emergency department (ED). The following scenarios were posed as part of the question. Scenario 1: A 68-year-old female presents to the treatment centre (FACEM lead) post fall and sustains a right wrist fracture & a laceration to her forehead. The patient is assessed by the FACEM which includes history, examination and organising investigations – some blood tests, ECG and X ray. As a part of treatment, the patient requires interpretation of an ECG, reduction of the fracture and application of plaster under a local block, and suturing of forehead laceration under local. Which code applies for the consult, is it 104 or 107? Which code applies for the fracture reduction and plaster application? Which code applies for the local block? Scenario 2: A patient presents with abdominal pain on a Sunday. The patient requires assessment by a FACEM, which includes, history, examination and organising investigations followed by treatment. Is seeing this patient on a Sunday considered an afterhours presentation? If yes, which code applies for the consult?

What constitutes a referral from the Emergency Department to an inpatient medical unit?

20 January 21

This is a common question. Who should the referrer be in these circumstances?

SUBSCRIBE TO MBS ANSWERS

It’s just $299 for a year and you get all of this:

Weekly mailer updates with the latest answers.

Monthly PIM newsletter (Payment Integrity Monthly), where we summarise all the latest PSR cases as well as any court or tribunal decisions involving health practitioners.

Priority answers when there are major changes to Medicare laws that the entire industry needs to know about.

The ability to submit questions.

Already a subscriber? Please Log in.

FREE TRIAL

See the complete answers to four popular questions.If you like what you see, you can join our yearly subscription for full access. Free trial will expire after 7 days.

Do you already have an AIMAC account?

YesNo

Name(Required)

First Name* Last Name*

Email*(Required)

Phone(Required)

Select at least one topic of Interest(Required)

Password

Enter Password Confirm Password

Oops! You need to be logged in to use this form.

Topics

Specialities

Nurse Practitioners

If a nurse practitioner and radiographer perform a PICC line insertion can a radiologist claim for the associated digital subtraction angiography?

Can a nurse practitioner bill Medicare for public outpatients when the nurse practitioner is simultaneously being paid by a hospital that does not have a section 19(2) exemption?

Can a fellow of the Australasian College for Emergency Medicine (FACEM) bill MBS codes outside of a private emergency department?

What constitutes a referral from the Emergency Department to an inpatient medical unit?

Topics

Specialities

Nurse Practitioners

Subscribe and save

Still want more?

Still not enough?

SUBSCRIBE TO MBS ANSWERS

FREE TRIAL